Dr. Natalie Bocking, chief medical officer of health with the Haliburton, Kawartha, Pine Ridge district health unit, said a decision over a potential amalgamation with Peterborough Public Health will be made in the next six weeks.
Speaking at a HKPR board meeting Jan. 18, Bocking said a draft report by consultant, Tony Yu and his firm Sense & Nous, will be presented to a joint board of health working group next week. Presentations will then be made to the HKPR board Feb. 5 and to the PPH board Feb. 6.
Local board of health members will discuss further at a Feb. 15 meeting, which will include officials from the Ministry of Health, Bocking said.
“We have scheduled a series of meetings that will hopefully bring the board to a point where it can make a decision by the end of February,” Bocking said, noting the province is accepting business cases for voluntary amalgamations until April 2.
Last August, the Ford government said it would provide funding to health units that want to merge as part of a provincial approach to clarify roles and responsibilities of public health. This follows a 2019 move to download more costs of public health care delivery to municipalities – with the province lowering its funding contribution from 75 per cent to 70 per cent.
Bocking said the consultants recently completed HKPR staff consultation, providing local feedback on any possible amalgamation. Several concerns were outlined, she said, including a fear relationships between public health and the community would get watered down with a larger organization.
There was also concern expressed about the leadership of a new, larger health unit, given Bocking and Thomas Piggott, PPH medical officer of health, are relatively new to their roles. Bocking joined HKPR in April 2021, with Piggott taking on his role in December 2021.
“[Comments received] suggests there has been a considerably positive culture shift at the respective organizations,” Bocking said, noting staff didn’t want to see any regression on that front.
Staff also asked questions about job security, what implications amalgamation would have on existing collective bargaining agreements, how additional work travel due to having a larger coverage zone would be handled, and what would happen if the boards decided against coming together.
Bocking said there has been considerable consultation with Curve Lake and Hiawatha First Nations, which have agreements for public health delivery with PPH, on how any amalgamation may impact them.
“We’ve had good discussions. What came through to me is the importance of not losing local connections in any merger… what works in urban Peterborough may not work in Haliburton County,” Bocking said.
Yu noted his team has put together a merger feasibility report that identifies how amalgamation will impact HKPR across all departments. The report also considers potential benefits of the merger.
“Based on our experience… any merger is possible, it just depends on how much effort you’re willing to invest, how much pain you’re willing to go through to see this through,” Yu said. “As a board of health, you need to think about not only the costs, but what are the possibilities that can be brought forward.”
Bocking said while a decision will likely be made by the end of next month, any merger is likely to be a long process.
“Once our board makes a decision, it has to go to the Ministry of Health for approval. That’s not going to happen right away. Even after we put a business case together, there will be an air of uncertainty because we don’t know 100 per cent if they’ll approve it,” she said, explaining there are no timeframes in place.
Cec Ryall, who represents Haliburton County on the board, asked how big a merged board of HKPR and PPH representatives would be. HKPR currently has seven representatives, while PPH has 13.
“Will every community, every Indigenous group be represented? If it becomes 20 people, how will that work? No decision is going to be made with a board that size,” Ryall said. “Haliburton County is one of the smallest municipalities (in HKPR). How are we going to be protected (to ensure we have a voice).”
Bocking said the makeup of a combined board would be discussed should both health units agree to a merger.
‘Tis the season
Bocking provided an update on the 2023/24 respiratory season, noting numbers are down this year and more in line with pre-pandemic levels.
She said there have been 44 COVID outbreaks in HKPR, resulting in 28 hospital admissions and 17 deaths. There has also been 111 confirmed cases of influenza, resulting in seven hospital admissions.
“While we’re not seeing waves of COVID the same way we did before, we’re still seeing illness associated with COVID,” Bocking said. “There’s a desire from all of us to pretend it’s behind us. It’s not… the new normal is COVID is part of the mix of respiratory viruses in our communities.”
HKPR chief medical officer of health Dr. Natalie Bocking said a decision on local health unit amalgamation.
